The role of nurse-driven protocols in the prevention of urinary tract infections in indwelling catheterized patients

Introduction
Catheterizing patients is one of the most frequently performed invasive medical procedures in daily clinical practice. The time a patient is catheterized is the most important modifiable factor that increases the risk for urinary tract infections. After a period of one month, bacteriuria is already detectable in urinalysis in nearly 100% of patients. Catheter-associated urinary tract infections (CAUTI) are recognized by the World Health Organization as a serious public health problem. The purpose of our paper is to summarize the current knowledge about catheter-associated urinary tract infections and review the latest available reports on the effectiveness of "nurse-driven protocols" in preventing these infections.

Material and methods
We searched the online databases of Google Scholar and PubMed. We finally selected 11 original articles published after 2016. Nurse-driven protocols in the prevention of CAUTI Studies in recent years confirm the effectiveness of "nurse-driven protocols" in the prevention of urinary tract infections. Each study achieved case reductions ranging from about 20% to as close as 100%. The studies involved varying numbers of nursing staff, with the shortest study lasting a few weeks and the longest 12 years.

Conclusions
Nursing staff, who are closest to the patient and provide direct care, play an extremely important role in preventing infections. The use of special protocols by nurses, based on appropriately selected check-lists, regular audits with feedback, and extensive staff education and competency improvement seem to have a key impact on reducing the incidence of urinary tract infections.